OBJECTIVE

To develop reperfusion algorithm allowing for more effective restoration of cardiac function after prolonged myocardial ischemia.

MATERIAL AND METHODS

Intra- and postoperative period was analyzed in 70 patients who underwent cardiac surgery. Patients were randomized into 2 groups: group 1 (main) — 35 patients with original algorithm of reperfusion period (carbon dioxide for prevention of air embolism), group 2 (control) — 35 patients with standard reperfusion period. All surgical interventions were performed under cold blood cardioplegia.

RESULTS

Controlled myocardial reperfusion and carbon dioxide for prevention of air embolism reduce the incidence of ventricular fibrillation after cardioplegia and recovery, as well as the need for inotropic support after reperfusion, ischemic changes in myocardium, rhythm and conduction disturbances. Favorable course of reperfusion period contributes to earlier recovery in intensive care unit as evidenced by shorter mechanical ventilation and ICU-stay.

CONCLUSION

The proposed reperfusion algorithm with carbon dioxide in cardiac surgery is used to ensure functional restoration of reversibly depressed cardiomyocytes through less impact of damaging factors on myocardium within several minutes after prolonged ischemia.